Prevalence of Mental Disorders in Punjab: Findings from National Mental Health Survey

Background: Knowledge of the prevalence of mental disorders is essential for setting up services and allocation of resources. Existing studies suffer from methodological problems which limit their utility and generalizability. There was a long felt need to conduct a scientifically robust study in different regions of India to have national prevalence rates. Aims: This study aims to estimate the prevalence of mental disorders in a representative population of Punjab as a part of the National Mental Health Survey. Settings and Design: Community-based survey carried out in rural and urban areas of Punjab using multistage, stratified, random cluster sampling technique and random selection was based on Probability Proportion to Size. Materials and Methods: The survey was conducted in 60 clusters of 4 districts (Faridkot, Ludhiana, Moga, and Patiala) of Punjab. Mini-International Neuropsychiatric Interview adult version 6.0 for mental morbidity, case definition for generalized tonic-clonic seizure, an expansion of the Fagerstrom Nicotine Dependence Scale for tobacco use and screener for intellectual disability were used. Appropriate statistical methods were applied. Results: A total of 2895 respondents aged >18 years from 719 households were interviewed. The prevalence of lifetime and current mental morbidity was 17.94% and 13.42%, respectively. Higher prevalence of mental morbidity was found among persons aged >60 years and those belonging to lower income group and rural population. Conclusions: The prevalence of mental morbidity is high in the population. The findings give a clear picture of magnitude of the problem and will help policy planners to tackle the situation which looks grave and warrants immediate intervention.

Introduction

The prevalence of mental disorders has been of great interest to the clinicians, researchers, and policy planners. Hence, large number of epidemiological studies have been carried out in India.[1],[2],[3],[4],[5],[6],[7],[8],[9],[10],[11],[12],[13] However, there are wide variations among the rates of mental disorders reported by different authors, and there has always been a dilemma to reach to an agreed prevalence rate. The major reasons for the variation in prevalence rates across various studies include factors such as definition of case, diagnostic criteria, sample size, types of psychiatric disorders included in the study, area of the study, and reliability and validity of the assessment tools used. To reach to an agreed prevalence rate of psychiatric disorders in India, few meta-analysis and reviews have been carried out by different researchers.[14],[15],[16],[17] The prevalence estimated in these meta-analysis and reviews varies from 58.2/1000population,[14] 73/1000,[15] and 190-200/1000 population.[17]

In a recent review, the authors have reported that the prevalence of mental disorders reported in Indian epidemiological surveys is lower than the accurate reflections of the true prevalence in the population.[16] The factors for underreporting might include collecting data from single informant, use of screening instruments with low sensitivity, poor sampling methods, and including only limited mental disorders.[16] Thus, these factors need to be kept in mind during mental health-care planning including allocation of resources. The authors further recommend the need of carrying out longitudinal and multicentric research on general population focusing on disability assessment, functioning, family burden, and quality of life of persons suffering from mental illness.[16],[17]

The current study is a part of the National Mental health Survey 2016,[18],[19] which was conducted in the state of Punjab as a part of larger survey in 12 states of India, to estimate the prevalence of mental disorders in a representative population in the state of Punjab.

Materials and Methods

Sample size

The sample size was calculated after a pilot study on 3190 individuals above 13 years of age in Kolar district of Karnataka and as advised and guided by the national expert consultation. …

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